Byungchul Park, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

011494 Issued in CT

Practice address

258 S Frontage Rd
New London, CT 06320-2641

Phone

(860) 437-3462

NPI assigned

Oct 6, 2015

Last updated

Oct 6, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clear Smile Dental Studio PLLC

  • General Practice Dentistry
  • Stamford, CT
  • NPI 1154952513
  NPD Authorized official
• Mount Kisco Dentistry

  • Dental Clinic/Center
  • Mount Kisco, NY
  • NPI 1508754102
  NPD Authorized official
• Kent Dentistry & Implants

  • Dental Clinic/Center
  • Kent, CT
  • NPI 1295505246
  NPD
• New London Dental Care, LLC

  dba New London Dental Care

  • General Practice Dentistry
  • New London, CT
  • NPI 1629364997
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1316317092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S FRONTAGE RD",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063202641",
            "telephone_number": "860-437-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S FRONTAGE RD",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063202641",
            "telephone_number": "860-437-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BYUNGCHUL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sreenivasulu Panguluri, DMD
• Heather Pannone, MSOT R/L
• Daria Papalia, PH.D.
• Katherine Paquette, LCSW
• Daniel F Parisi, DMD
• Stefanie Parks
• Franca Maria Parra-Polimeni
• Brianna Passeri
• Keyur Patel
• Rita B. Patel

• General Practice Dentistry in New London, CT
• Providers in New London, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.